Medical-Denial Management Specialist

ORTHOPEDIC ASSOCIATES OF HARTFORD; Farmington (CT); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Orthopedic Associates of Hartford in Farmington, CT is seeking a Medical-Denial Management Specialist with Epic experience to join our Billing & Collections team in a hybrid office setting. The ideal candidate will analyze and resolve insurance denials, prepare appeals, and collaborate with staff to ensure proper reimbursement.

Responsibilities include claim follow-up, data entry, and interaction with internal departments.

Qualifications

• Two years’ recent experience in medical collections or medical billing.
• Familiarity with ICD-10 coding and HIPAA regulations.
• Proficiency with Epic, MS Word, Outlook and Excel.
• Excellent written and verbal communication.

Responsibilities

• Follow policies and procedures; timely, accurate follow up on claims for resolution of balances.
• Participate in the collection and documentation of claims processing rules.
• Generate electronic and hard copy claims for submission.
• Obtain supporting documentation to ensure claim acceptance.
• Interact and communicate effectively with interdepartmental units as needed.
• Document account information for claims submission and resolution.
• Enter demographic data into the billing and collections software.
• Assume other duties as needed.

Skills

Medical billing

Medical collections

Analytical skills

Communication

Teamwork

Problem solving

Education

High School diploma

Tools

Epic

Microsoft Word

Outlook

Excel

Electronic billing

Job description

Medical-Denial Management Specialist

Orthopedic Associates of Hartford Farmington, Connecticut, United States

About this position

Description:

Established in 1970, Orthopedic Associates of Hartford, P.C., is one of the areas largest orthopedic practices with office locations throughout greater Hartford. Our growing practice is currently seeking a Medical-Denial Management Specialist with Epic experience to join our Billing & Collections team in our Farmington, Connecticut business office. This is a hybrid position requiring regular onsite attendance in Farmington, CT. Candidates should/need to be within commuting distance of the office.
The Medical-Denial Management Specialist analyzes and resolves healthcare insurance claim denials by investigating reasons, preparing appeals, communicating with payers, and collaborating with billing staff to ensure proper reimbursement and prevent future denials. Thís role requires strong analytical, communication, and problem-solving skills, along with a thorough understanding of insurance policies, medical terminology, and healthcare billing procedures. The successful candidate will be a team player who is dependable, organized, enthusiastic, and detail oriented. Important to this position is the ability to build relationships with our customers, both internal and external, to promote feedback and timely resolution of outstanding claims. Proficiency in many computer software programs is required as well as an understanding of insurance payment methodologies to insure accurate reimbursement. A positive "can-do" attitude is a must.

Responsibilities include:

• Following policies and procedures, timely and accurate follow up on claims for the resolution of outstanding balances.
• Participates in the collection and documentation of claims processing rules.
• Generates both electronic and hard copy claims for submission.
• Obtains supporting documentation and other information required to insure acceptance of claim.
• Interacts and communicates effectively with interdepartmental units when necessary.
• Documents account information pertaining to claims submission and resolution.
• Enters demographic data into the billing & collections software.
• Assumes other duties and responsibilities as needed.

PM22

Requirements

• Two years recent experience in medical collections and/or medical billing with result oriented debt collections skills.
• Familiarity with ICD-10 coding and Federal HIPAA regulations.
• Computer skills, including Epic, electronic billing, Microsoft Word, Outlook and Excel.
• Excellent written and verbal communication skills with a professional and courteous telephone manner.
• High School diploma.